Coming through heart surgery

PORTSMOUTH — Jessica Hulseman has a photograph of her heart taken during surgery at Portsmouth Regional Hospital last year to remove a 7-millimeter benign tumor from her aortic valve.

Suzanne Laurent

PORTSMOUTH — Jessica Hulseman has a photograph of her heart taken during surgery at Portsmouth Regional Hospital last year to remove a 7-millimeter benign tumor from her aortic valve.

"I haven't framed it yet," she said, smiling at her cardiac surgeon, Dr. Donato Sisto, when they met at the hospital last week to talk about her experience.

Sisto said Hulseman went through a trying time last year when the tumor was discovered. But surgery was really the best option as it was like playing Russian roulette to leave the tumor on the valve. "Pieces of it could break off and actually cause a stroke," Sisto said.

Hulseman, then 43, had gone to her primary care provider, Amy Coombs, an adult nurse practitioner at Whole Life Health Care in Newington about a year and a half ago.

"I've had a heart murmur that I've known about for six years," Hulseman said. "So I had a routine EKG (electrocardiogram)."

Hulseman said "something didn't look right," so Coombs ordered further testing. She underwent a transesophageal echocardiogram.

A transesophageal echocardiogram is performed by inserting a probe with a transducer down the esophagus rather than placing the transducer on the chest in a transthoracic echocardiogram.

Certain conditions of the heart, such as mitral valve disorders, blood clots or masses inside the heart, dissection (tearing) of the lining of the aorta and implanted prosthetic (artificial) heart valves, are better visualized and assessed with this procedure.

"I had no symptoms that anything was wrong," said Hulseman, 44. "I've been healthy and active all my life."

Hulseman said it was a "huge shock," and she needed time to process the fact she would need major cardiac surgery to remove the tumor or risk having a stroke.

Her cardiologist, Dr. Lance Briggs, advised her not to wait too long. She consulted with Sisto, who actually sent her echocardiogram videos to two colleagues in New York and Italy for their opinion.

"After I got over the initial denial phase, I decided to go ahead with the surgery," Hulseman said.

The mother of three daughters and two soon-to-be stepdaughters, Hulseman said she planned her surgery around the girls' graduations. "My oldest daughter was a senior at the University of Edinburgh," she said. "I also had one graduating from high school and one from eighth grade."

Hulseman had her surgery on May 16, 2013. Sisto said he made a limited incision that would be less intrusive on Hulseman's sternum. It was not without risk, and Hulseman's heart had to be stopped during the surgery to remove the tumor as gently as possible.

"These types of benign tumors are not common," Sisto said. "There is not much known about them and about 2 percent of them grow back."

Hulseman will be monitored every year with echocardiograms.

She has lived in Portsmouth for about 10 years and is active in many local organizations. She said she began talking with people before her surgery and found others sharing their stories about having heart surgery at Portsmouth Regional.

"This helped lead me to my decision to stay local," Hulseman said. "I thought I would feel so alone if I went down to Boston."

She was in the hospital for five days and just 10 days later she was at her daughter's high school graduation. After six weeks, she was able to fly overseas for her oldest daughter's graduation. One of her future stepdaughters was also graduating from college at the same time.

It took Hulseman about five months to get her energy back and feel like she was truly on the mend.

"What I wasn't prepared for was the emotional aspect of healing," she said. "I later found out that in younger patients and in women, the side effects after surgery can be intense."

Hulseman credits Coombs for ordering the further testing after her routine EKG for preventing a much more devastating outcome if she had suffered a stroke.

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